THE AIDS TITANIC
Do you remember a scene in "Titanic", just after the ship hit the iceberg?
The loud noise, and the frightening jolt, had ceased. The ship was just
sitting, quiet and still. The lights were bright, the people were standing,
well-dressed, drink in hand, on the dance floor. The children were tucked
away in bed. Everything seemed normal. Some clueless, whiny passengers
started demanding to know why they were just sitting there, when they were
going to get underway again.
Everyone knows that some 30 million people are infected with AIDS, so
it seems very peculiar to suggest that perhaps we are failing to grasp the
full significance of the epidemic.
There was an early frightening jolt with AIDS, but we seem almost calm,
now. Maybe it is because it seems like just the riff-raff (the lower-class
passengers) who bear the brunt of it, while the "nice" people (the first
class passengers) have little to worry about, if they follow the rules.
We depend on certain assumptions to keep this rosy confidence: AIDS
does not spread through the air, spread through kissing or saliva, spread
through insects. The blood banks can screen for it.
The public seems to think that these assumptions are timeless and
unchanging. Unfortunately, the virus itself is changing all the time.
Twenty years ago, we assumed that sex involved no fatal diseases.
This assumption was not timeless was, it?
HIV is virtually without peer in its ability to change, among
deadly viruses.
Flu is normally harmless, but also changes all the time, just not as
quickly and dramatically as HIV. For most changes, it remains
relatively harmless. However, when there is a major change, it
can become most deadly, a killer of millions.
AIDS is anything but harmless, even in its "normal" state. How
much more harmful could it get?
HIV essentially forms a slightly different virus in every individual
host. One of the current theories to explain HIV's long latency says
that the immune system DOES fight off the virus, for long periods.
However, the virus keeps changing. Time and probability, through
the random mutations, work to the benefit of the virus, in eventually
evading the immune system, and overcoming the host.
In the worst-case scenario, what is true for an individual host, could
in a broader sense be true for the entire species. If the virus changes
enough over time to spread in new ways, to evade our blood
screening, to kill more efficiently, then it "overcomes" our defenses
as a society.
Not every change of the virus would cause it to become undetectable.
As an analogy, say that you prevented humans from committing
crimes, because you had their fingerprints on file, and could detect
them if they tried anything.
You could mutate quite a bit- say that you now have the head of
a donkey. Yet, if your fingerprints are the same, you can still be
caught if you commit a crime.
On the other hand, say that the only changes are your fingerprints,
and you otherwise look exactly the same. The change has rendered
you undetectable, for forensic purposes, and you can now get away
with murder (of your host).
There is an inconceivably large number of possible variations on
the virus.
There is some argument that AIDS can already be spread effectively
by insects. Without even getting into this argument, it could certainly
be imagined that new variations of the virus might break any of
our assumptions- how long the virus lasts outside the body, whether
it could spread by sneezing, etc.
You could try to fight back, if need be, with things like testing
and quarantine. Trouble is, you can't test for what you can no longer
identify. You can't quarantine what you can't find.
The worst-case scenario is a species-destroying virus. It's possible,
but how likely is it? I'm not sure that anyone knows, in a meaningful,
quantitative sense. I'm not sure that anyone would tell us truthfully,
even if they knew.
Hitting the iceberg is analogous to the initial scare that AIDS caused.
The quiet, still-comfortable ship is analogous to the complacency over
AIDS that seems to have set in many quarters.
The clueless passengers are analogous to... pardon me for saying this...
are analogous to you, the Reader, the John Q. Public.
There seemed almost a poetic justice in the sinking of the Titanic- the
people running the ship were so arrogant, greedy, lacking in compassion.
They are analogous to the right-wingers who run our Ship of State.
It would be an almost poetic justice to the right-wing forces that at
best did not care, or at worst actively conspired in bringing about the
epidemic. There would also be a measure of justice to the many who
turned a blind eye to the madness and misdeeds of the ruling powers
that they had sanctioned.
I am just sitting on the iceberg, adapted to the cold like a walrus, watching
with my binoculars to see what happens, keeping a journal of all that
transpires. I'll let you know what happened, as I certainly intend to
make a romantic movie of it.
Tom Keske
Boston, Mass.
